Differential Diagnosis Fever

with Rash
Infectious causes

 Macule: nonpalpable,
circumscribed, flat lesion (<1 cm
in diameter)
- Papule: palpable , elevated
lesion (<1 cm in diameter)
- Maculopapular: combination
of macular and popular lesions
- Purpura: non-blanching
papules or macules due to
extravasation of RBCs

 Vesicle: fluid-filled, elevated

skin lesion (<1 cm in
diameter)
- Bulla: fluid-filled,
elevated skin lesion (>1 cm
in diameter)
- Pustule: pus-containing
vesicle
- Ulcer: depressed skin
lesion with missing epidermis

Measles
Blanching erythematous
maculopapular rash
Begins in head and neck and spreads
centrifugally to trunk and
exrtremities
Associated symptoms: fever, cough,
and conjunctivitis

Chickenpox
Vesicular lesions on erythematous
base
Lesions appear in crops
dew drops on rose petals
appearance
Lesions are present in different
stages: papules, vesicles, crusting

Rubella
Rash resembles measles, but patient
is not ill looking
Prominent postauricular, posterior
cervical +/- suboccipital adenopathy
Forschemier spots: small, red spots
(petechiae) on soft palate in 20% of
rubella patients

Erythema infectiosum (fifth disease)

human parvovirus B19
Characteristic rash that resembles
slapped cheeks
Lymphadenopathy is absent.

Roseola infantum or exanthema

subitum

Human herpesvirus 6 or 7 infection

- High fever for 3-4 days
- Followed by seizures
- Generalized rash (trunk to
extremities, face spared)

Scarlet fever

Exotoxin-mediated diffuse
erythematous rash
Pharyngitis due to group A
streptococcus
Coarse, sandpaper-like,
erythematous, blanching rash
desquamation
Circumoral pallor and strawberry
tongue

Hand, Foot, and Mouth Disease

(Coxsackie Virus)
A blistered rash appears on the
palms, on the soles of the feet,
and/or in the mouth.
The rash hurts and is usually
accompanied by a fever.

Differential Diagnosis Fever without

Rash

Fever of unknown
origin(FUO)
Fever for longer than 14 days
without an identified etiology
despite history ,physical
examination and routine
laboratory tests or after 1 week
of hospitalization and evaluation.